This bill amends the Independent Health Care Appeals Program in New Jersey to promote equity in the health insurance appeal process by eliminating the application processing fee for appeals against health insurance carriers. Specifically, it removes the requirement for covered persons to pay a $25 fee when applying for a review of a carrier's decision to deny, reduce, or terminate benefits. The bill also allows the commissioner to waive fees in cases of financial hardship, but this provision is no longer necessary due to the complete deletion of the fee requirement.

Additionally, the bill enhances the rights of covered persons by allowing them to authorize health care providers to appeal decisions on their behalf through a consent form, which remains valid throughout all stages of the appeals process. Health care providers are also mandated to notify covered persons whenever they initiate or continue an appeal, ensuring transparency and communication throughout the process. This legislation is part of the Governor's Fiscal Year 2026 budget recommendations aimed at improving access to health care appeals for consumers.

Statutes affected:
Introduced: 26:2S-11